Treatment Outcomes, Common Factors, and Continued Neglect of Mechanisms of Change.
Abstract
In this commentary, three key theses are advanced. First, the presence or absence of differences among two or more treatments in a therapy outcome study does not necessarily have implications for the role of common factors as an explanation of treatment effects. Common factors can vary widely among conditions, whether they are veridical treatment or control conditions, and might explain outcome differences or the absence of differences. Second, the therapeutic alliance literature, although vast, also cannot be used to support or refute a common-factors view. Fundamental issues include establishing the timeline of alliance and symptom changes; delineating alliance from other client, therapist, and other aspects of treatment; and identifying and testing the specific ways in which alliance produces change are far from resolved. Third, key lines of research continue to be neglected that could elaborate the role of common factors. Direct tests of common factors, especially experimental studies that manipulate factors to alter outcome, would be enormously valuable. In addition, attention to the mechanisms of therapeutic change where specific mechanisms have been proposed is needed.
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Some elements are considered unique and specific to CBT.
“Some elements are considered unique and specific to CBT [73–75].”
From A Sequential Multiple Assignment Randomized Trial (SMART) study of medication and CBT sequencing in the treatment of pediatric anxiety disorders (2021) · cites this paper as [74]
Cites
Determinants of change in cognitive therapy for depression
DeRubeis, R. J., & Feeley, M. (1990) · Cognitive Therapy and Research · doi:10.1007/bf01172968 · Cited by 401 · see citing works
Klein, D. N., Schwartz, J. E., Santiago, N. J., Vivian, D., Vocisano, C., Castonguay, L. G., Arnow, B., Blalock, J. A., Manber, R., Markowitz, J. C., et al. (2003) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.71.6.997 · Cited by 264 · see citing works
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Baldwin, S. A., Wampold, B. E., & Imel, Z. E. (2007) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.75.6.842 · Cited by 646 · see citing works
Disruptive innovations for designing and diffusing evidence-based interventions
Rotheram-Borus, M. J., Swendeman, D., & Chorpita, B. F. (2012) · American Psychologist · doi:10.1037/a0028180 · Cited by 210 · see citing works
Morrell, C. J., Sutcliffe, P., Booth, A., Stevens, J., Scope, A., Stevenson, M., Harvey, R., Bessey, A., Cantrell, A., Dennis, C.-L., et al. (2016) · Health Technology Assessment · doi:10.3310/hta20370 · Cited by 155 · see citing works
Falkenström, F., Ekeblad, A., & Holmqvist, R. (2016) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000119 · Cited by 103 · see citing works
Price, M., & Anderson, P. L. (2012) · Psychotherapy · doi:10.1037/a0024734 · Cited by 99 · see citing works
Newman, M. G., & Fisher, A. J. (2010) · International Journal of Cognitive Therapy · doi:10.1521/ijct.2010.3.3.245 · Cited by 83 · see citing works
Ahmed, M., & Westra, H. A. (2009) · Cognitive Therapy and Research · doi:10.1007/s10608-008-9182-1 · Cited by 63 · see citing works
Mechanisms, determinants and processes of change in the modification of drinking behavior
DiClemente, C. C. (2007) · Alcoholism Clinical and Experimental Research · doi:10.1111/j.1530-0277.2007.00489.x · Cited by 58 · see citing works
McKay, J. R., Lynch, K. G., Coviello, D., Morrison, R., Cary, M. S., Skalina, L., & Plebani, J. (2010) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0018139 · Cited by 46 · see citing works
“There is considerable evidence that a strong therapeutic alliance and other general factors in psychotherapy and counseling predict better outcomes in the treatment of addiction (Connors, Carroll, DiClemente, Longabaugh, & Donovan, 2007) and other disorders (Baskin, Tierney, Minami, & Wampold, 2003; Kazdin, 2005; Orli…”
BackgroundNewman, M. G., & Fisher, A. J. (2013) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0031690 · Cited by 45 · see citing works
“Showing that a particular treatment works better for those with longer duration GAD may provide some information; however, this doesn’t elucidate how and why a particular treatment might work better for these individuals (e.g., Kazdin, 2005, 2007; Kraemer, Wilson, Fairburn, & Agras, 2002).”
BackgroundCommon (Nonspecific) Factors in Psychotherapy
Huibers, M. J. H., & Cuijpers, P. (2015) · The Encyclopedia of Clinical Psychology · doi:10.1002/9781118625392.wbecp272 · Cited by 39 · see citing works
Arnfred, S. M., Aharoni, R., Hvenegaard, M., Poulsen, S., Bach, B., Arendt, M., Rosenberg, N. K., & Reinholt, N. (2017) · BMC Psychiatry · doi:10.1186/s12888-016-1175-0 · Cited by 31 · see citing works
Dalrymple, K. L., Morgan, T. A., Lipschitz, J. M., Martinez, J. H., Tepe, E., & Zimmerman, M. (2014) · Behavior Modification · doi:10.1177/0145445513518422 · Cited by 22 · see citing works
“More recently, the literature has emphasized the importance of determining what elements of treatment packages are effective relative to others and identifying mediators and moderators of outcomes, rather than only testing large treatment packages against each other (Kazdin, 2005).”
BackgroundPeterson, B. S., West, A. E., Weisz, J. R., Mack, W. J., Kipke, M. D., Findling, R. L., Mittman, B. S., Bansal, R., Piantadosi, S., Takata, G., et al. (2021) · BMC Psychiatry · doi:10.1186/s12888-021-03314-y · Cited by 13 · see citing works
Draheim, A. A., & Anderson, P. L. (2019) · The Cognitive Behaviour Therapist · doi:10.1017/s1754470x19000266 · Cited by 8 · see citing works
- Authors
- Kazdin, A. E.
- Venue
- Clinical Psychology: Science and Practice
- Published
- 2005
- Volume
- 12
- Issue
- 2
- Pages
- 184-188
- ISSN
- 1468-2850
- 0969-5893
- Cited by
- 41
- References
- 2
- Language
- en
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